Irritable bowel syndrome - a violation of bowel function, manifested by abdominal pain and / or impairment of defecation. Irritable bowel syndrome develops as a result of psychological and other effects on the intestine reacts excessively.
Irritable bowel syndrome - the most common disease of the internal organs. It can manifest itself at any age, including children. In women, the disease occurs in 2-3 times more often.
Despite the extraordinary prevalence of irritable bowel syndrome, about 75% of the adult population do not feel sick and do not seek medical help.
The origin and development of the disease are important psycho-emotional disorders.
Manifestations of irritable bowel syndrome
Leading symptoms of irritable bowel syndrome are pain, abdominal discomfort, and violations of the chair. Frequently in the stool you can see a large amount of mucus. Spasm of different intestine there is not constant and can change the location on different days.
Patients with irritable bowel syndrome has a lot of extra-intestinal symptoms, some of which are linked to dysfunction of other organs of the digestive system, and the other - with disorders of the nervous system and psychological status. Recent become a cause of fatigue, weakness, headaches, loss of appetite,
sleep disorders, Palpitations, sweating, seizures "lack of air", pollakiuria, small temperature increase and so on. D.Irritable bowel syndrome is frequently observed body mass deficit, but it is not associated with malabsorption of nutrients, and with features of mental status or bad appetite.
Quality eating disorders manifested by dryness and peeling of the skin, change its color (a kind of dirty gray shade), the appearance of age spots on the face, hands and legs.
There are three main types of irritable bowel syndrome: a predominance constipation, With a predominance of diarrhea and prevalence of pain.
Diagnostics
The diagnosis of irritable bowel syndrome can be made based on a typical manifestation in the absence of other diseases of the intestine, which are excluded during the study the other.
Currently, the diagnosis of irritable bowel syndrome in adults use "Rome criteria-II (2000)": for at least 12 weeks (Not necessarily the next one after the other) in the last 12 months, there are abdominal discomfort or pain that has at least two of the following three characteristics:
- decrease after a bowel movement;
- start due to a change in frequency of stool;
- start due to the change in stool form.
Irritable bowel syndrome is diagnosed only if the communication of pain and discomfort in the stomach with a chair. Pains appear in front of a chair and subside after a bowel movement, and a dependence on changes in regularity or stool consistency.
Several features are not characteristic of irritable bowel syndrome which may indicate the presence of other diseases.
- proctorrhagia
- Reduction in body weight
- chronic diarrhea
- Anemia
- Fever
- Onset of the disease in persons over 50 years
- Family history (cancer, inflammatory bowel disease from their parents)
- The appearance of pain and diarrhea at night
Rectal bleeding can be caused by hemorrhoids; decrease in body weight, and low-grade fever - symptoms depression or hypochondriacal syndrome.
Treatment of the syndrome with constipation-predominant and diarrhea
Treatment of irritable bowel syndrome should be comprehensive.
Diet with the syndrome
With the prevalence of constipation is a diet supplemented with wheat bran.
In the case of the prevalence of diarrhea is recommended to limit foods rich in fiber (vegetables, fruits, bran).
Everyone, without exception, patients with irritable bowel syndrome are advised to observe exclusion diet that does not contain caffeine, lactose, fructose, sorbitol, vinegar, alcohol, pepper, smoked, as well as products that cause excessive flatulence - milk, sour milk products.
Correction of psycho-emotional disorders
Of actions aimed at improving CNS functions and correction of autonomic disorders include psychotropic drugs, rational therapy. Advantageously, the diagnosis of psycho-emotional disorders and their removal should be dealt with neuropsychiatrist and psychotherapist.
Anti-bacterial and bacterial preparations
The indications for use of antimicrobials in irritable bowel syndrome are diarrhea, flatulence and abdominal pain.
Apply antimicrobials courses on 10/07/14 days. recommended
- furazolidone,
- ersefuril,
- metronidazole (Trichopolum)
- and intetriks, nitroksolin and nevigramon.
After antibiotic therapy recommended long (up to 1.5-2 months) receiving bacterial preparations (probiotics) and laktobakterina bifidum, bifiform, hilak Forte et al.
When diarrhea effect have Imodium (loperamide) and alosetron.
With the prevalence of constipation and motilium Cerucalum shown.
When persistent pain have a good effect ditsetel and Duspatalin (mebeverin).
All patients with irritable bowel syndrome with diarrhea exacerbation prescribe binding agents: smectite dermatol, Tanalbin, white clay, as well as decoctions of herbs similar effect (chamomile, peppermint, hypericum, alder cones, blueberries and wild cherry). For the same purpose can be used, some antacids (almagel, Aluminum phosphate gel, Maalox) and preparations containing bismuth (Venter).
Irritable bowel syndrome with constipation-predominant necessary to develop the lost morning defecation reflex and to increase dietary fiber quantity by introducing into it wheat bran. To stimulate defecation in the first stage production lost reflex be administered the evening before Duphalac (lactulose) 1-2 dessert spoons. Accustom themselves to defecate every morning.
Forecast
The condition of patients with irritable bowel syndrome, treatment efficiency and the forecast is largely dependent on the severity of concomitant disorders of the nervous system. In order to achieve the recovery of crucial importance often has to overcome the conflicts that cause the formation of a neurosis in the patient.
Disabled patients with irritable bowel syndrome and prognosis of this disease is largely dependent on the severity of accompanying psycho-emotional disorders.
